LIFETALK: Is getting to normal weight and staying there worth the effort?

February 27, 2014

We are in the throes of an obesity epidemic. For nearly everyone, permanent weight-loss is a losing battle and regain, even for those who initially lose at least 10 percent of their body weight, is the norm.

With extreme measures, huge initial weight losses are possible. In 1975, Dr. Kempner, MD, the founder of the ground-breaking Rice Diet in Durham, N.C., reported helping 106 massively obese patients lose an average of 139 pounds each, without hospitalization or surgery. Nevertheless, according to Dr. Kempner, "The criterion of ultimate success of any weight reduction program is dependent on long-term maintenance of weight loss."

Meanwhile, the Rice Diet has shut its North Carolina home after 70 years. Their customers dwindled as weight-loss outcome research became more illuminating and other diet approaches, including the use of self-monitoring software and stomach surgeries, became popular.

Here's the rub: In spite of a media blitz and billions of dollars spent on remedies for overweight and obesity in the U.S., only a diminishing one-third of people are in the normal weight range. One-third are overweight and one-third obese, with the heaviest-ever expanding-5 percent carrying at least an extra 100 pounds.

Nevertheless, there is now a chink of light in the long-term outcome results.

An important and unique study of the National Weight Control Registry (NWCR) led by J. Graham Thomas, Ph.D. that was just published in the American Journal of Preventive Medicine proves that long-term weight loss is possible, but it requires sustained behavior change.

In that 10-year study, 2,886 participants, successfully maintained an average weight loss of 50.93 pounds after 10 years. The National Weight Control Registry (NWCR) tracks the weights, eating and exercise habits of thousands of participants. More than 87 percent of participants in this study were estimated to still be consistently maintaining a weight loss of at least 10 percent of their original weight after 10 years.

Entry requirements for the NWCR, of which I am a member, are the loss of at least 30 pounds, maintained for at least one year. You can find out more about the habits of their members and their relevance to you at www.nwcr.ws.

My weight peaked about 15 years ago at 189 pounds on my 5-foot, 3-inch frame. By applying what I have learned from research, I have been able to stay in a normal weight range -for my height, between 107 and 139 pounds-for almost 14 years.

I used to believe that if I could just get to normal weight I would be able to eat without restrictions, as everyone else seemed to be doing. This is a common misconception. Research has proven that the reduced person has a more compromised body chemistry than someone who is at the same weight but has never been heavy. Significant long-term weight loss is much more difficult and certainly rarer than short-term weight loss followed by an even more hefty weight gain.

In 2014, I still have to be attentive and active to keep my weight off-walk more than 3 miles per day, swim a few miles per week and eat less than an average of 1,500 calories per day to maintain my weight of 115 to 118 pounds. Getting to that weight was a lot more demanding.

Demystifying weight loss and learning what it actually would take for you or those you know to reduce to a normal or even ideal weight is the first step. Don't be taken in by quick weight-loss schemes. Think clearly about your course of action. The benefits of a trim body include not just the thrill of looking great but the verifiable outcome of a much-longer, healthier life.

Study the successful long-term weight loser. Once you know the price in planning and effort to achieve permanent weight loss, you can ask yourself if it is really worth it to do what you have to do.

For me, the answer is a resounding "Yes!" Losing my extra fat was not as onerous as it might seem, because I had company. You can, too. Maintaining an ideal or normal weight does get easier with companions and practice. The rewards are delightful. I have learned to enjoy my exercise, integrating it seamlessly into my social life, as often as I can. Walking dates with people whose company I take pleasure in makes exercise fun. Avoiding hunger by carefully eating a sufficient volume of food, including low-calorie-density vegetables and fruits, keeps me satisfied and healthy.

The most crucial component for my success is that I share my weight and a food and exercise log, daily by email, with once-heavier companions who find that the same research-supported methods also allows each of them to maintain a normal weight, without costs. This sort of routine was unimaginable to me when I was heavy. It adds significance to what once was a lonely and unsuccessful endeavor.

You can learn more about the results of our free World-Wide Calorie and Exercise Logging group at www.permanentweightloss.org. I came upon this method by adapting the demonstrably successful calorie and exercise logging results of the research-backed Trevose Group as reported on my website.

There is growing evidence that permanent weight loss is clearly achievable. Another recent report from Look AHEAD (Action for Health in Diabetes), a multi-center controlled clinical trial of lifestyle intervention for adults with type 2 diabetes, reported that 42 percent of 887 participants who lost at least 10 percent of their body weight at Year 1, maintained at least a 10 percent weight loss at four years. The treatment is long-term as is its effect.

The best way to find a permanent solution to weighing too much for your own good is to study those who have succeeded in getting from over-fat to normal weight and staying there for life.

Here's some eye-opening long-term predictive behavior revealed in the first year of weight-loss follow-up, just reported in the NWCR study: If in the first year after your initial weight loss, the danger zone, you increase your percentage of calories from fat, weigh yourself less frequently, reduce your leisure time caloric expenditure and or your restraint, you are more likely to have gained weight even 10 years later.

You can learn what it takes for you to achieve your weight-loss goals by monitoring your own behavior and adjusting it accordingly. Track your behavior. Losing 1 pound of fat means you must burn 3,500 calories more than you eat. Walking 1 mile burns an average of 100 calories.

Obesity is a time bomb. Early death from the complications of diabetes 2, cardiovascular disease, and cancer can be ameliorated by lifestyle changes.

Do you think it is worth the time and effort to learn and do what it takes to sufficiently change your way of life to achieve your long-term weight and health goals? Feel free to contact me if the methods depicted on www.permanentweightloss.org appeal to you.

Roberta Russell is the founder of the World-Wide Calorie & Exercise Logging Group (www.permanentweightloss.org). She is the author of "RD Laing & Me: Lessons in Love" and "Report on Effective Psychotherapy: Legislative Testimony." Send letters to russellk100@gmail.com.